Comparison between the effects of intravenous Lignocaine & Ketamine on postoperative pain after Ear, Nose and Throat surgeries.

Adequate post operative pain management is an essential part of perioperative care because postoperative pain causes patient discomfort and may reduce patient satisfaction. More importantly, it can increase the risk for pulmonary and cardiovascular complications and may even lead to the onset of chronic pain. Rates of absence from work for more than 2 weeks following routine ENT surgery and rates of readmission or overstay after nasal surgery are more than 10% suggesting that this patient group cannot be neglected. Pain levels experienced by patients who have undergone an ENT procedure are probably underestimated. Recently there is a growing interest in the use of different analgesic adjuncts like intravenous infusion of local anesthetics (eg, Lignocaine) and NMDA receptor antagonist (eg, Ketamine). Lignocaine is a local anesthetic which mainly acts as a voltage-gated sodium channel blocker and has analgesic, anti-hyperalgesic and anti-inflammatory properties. Ketamine has good analgesic properties and prevents the development of central sensitization, hyperalgesia and opioid resistance when administered in sub-anesthetic doses. Recent studies in this field have shown mixed results and there is paucity of research trials on post-operative pain in ENT surgeries hence, this study was planned.